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12182312 tn?1427683956

rheumatologist appointment

Hi guys. Went to my rheumatologist today. He was very very thorough. Asked me about my symptoms, medical history, and lab work. I have a positive ana, and anti dsdna. Also high crp levels. He ordered some more lupus tests as well as other labs. He said he didn't want to diagnose me until he has the lab work back cause my ana did not have  a titer. I thought, a anti dsdna is a definite for lupus. I'm glad I'm getting more labs and a repeat on my labs I have had. Just wondering why he would still be questioning it with a ana, anti dsdna, Crp and sed rate all positive...
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1530171 tn?1448129593
A Lupus dx is a very difficult one and it may take a long time to get.
Higher titres of anti-dsDNA antibodies are more suggestive of SLE , however lower titres can be found in people without the disease.
Do you know your result?

BTW there's no one single test for a Lupus dx.
A minimum of 4 out 11 criteria must be met in order to confirm a Lupus diagnosis.
Also, many tests results, even when positive, are not considered positive
for diagnostic purposes if below a certain threshold.
For example if your ANA titre is 1:40, 1:80 even 1:160 sometimes would not be of diagnostic value , as a number of  healthy subjects may also have low positive titres.

I hope this helps.
Niko

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12182312 tn?1427683956
Thank you. What does your number have to be in order for a diagnosis?
Helpful - 0
1530171 tn?1448129593
Hi kelle. You're welcome!

Depends on the Rheumatologist.
Some will consider 1:160 and others will consider only the 1:320 titre.
And having said this, the ANA is just one of the 4 minimum diagnostic
criteria for a Lupus dx.
See the following list of the criteria"

--Malar rash: butterfly-shaped rash across cheeks and nose
--Discoid (skin) rash: raised red patches
--Photosensitivity: skin rash as result of unusual reaction to sunlight
--Mouth or nose ulcers: usually painless
--Arthritis (nonerosive) in two or more joints, along with tenderness, swelling, or effusion. With nonerosive arthritis, the bones around joints don’t get destroyed.
--Cardio-pulmonary involvement: inflammation of the lining around the heart (pericarditis) and/or lungs (pleuritis)
--Neurologic disorder: seizures and/or psychosis
--Renal (kidney) disorder: excessive protein in the urine, or cellular casts in the urine
--Hematologic (blood) disorder: hemolytic anemia, low white blood cell count, or low platelet count
--Immunologic disorder: antibodies to double stranded DNA, antibodies to Sm, or antibodies to cardiolipin
--Antinuclear antibodies (ANA): a positive test in the absence of drugs known to induce it.

I can't tell with certainty, but your photo indicates myxedema, a hallmark characteristic in hypothyroidism, which, as I have mentioned before,
is an underlying condition in most Lupus cases, or it precedes Lupus development according to Dr. Broda Barnes, the renowned thyroid expert.
please consider going back to my post, where I mentioned this, read the details again and if it makes any sense to you, take this information to your doctor to confirm or rule out low thyroid function, by getting the right tests that I mentioned.
It's easier to deal with hypothyroidism than Lupus and even with a Lupus diagnosis, life is easier when the thyroid is well regulated,
I have a few friends with Lupus, who I'm coaching at present.  

Take care,
Niko
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